Exploratory Seizure Findings From INDIGO: Vorasidenib and Seizure Control

Seizure control remains one of the most clinically meaningful outcomes for patients with IDH-mutant glioma, particularly given the substantial impact epilepsy can have on quality of life, independence, and long-term neurologic functioning. While progression-free survival has traditionally served as a major endpoint in glioma trials, there is increasing recognition that therapies capable of influencing seizure burden may provide an additional layer of clinical benefit.

In this Special Report, Ugur T. Sener, MD, consultant in the Section of Neuro-Oncology and chair of the Division of Neuro-Oncology at Mayo Clinic, reviews exploratory seizure findings emerging from the phase 3 INDIGO trial evaluating vorasidenib in IDH-mutant glioma. Building on the mechanistic understanding of 2-hydroxyglutarate and tumor-associated epilepsy, the discussion explores how targeted IDH inhibition may influence both tumor biology and seizure activity over time.

In this episode, Sener summarizes exploratory analyses from INDIGO that evaluated seizure frequency among patients treated with vorasidenib compared with placebo. He also discusses observed relationships between tumor volume and seizure burden, along with potential mechanisms through which IDH inhibition may improve seizure control in this patient population.